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~. <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />,, i~~ iiirr«~u~~~ ~~~ <br />Lazy A Corporation <br />M-77-407 <br />Cedar Creek Pit <br />01/30/90 <br /> <br />~'7 ~~u ~'~ !~~ ~1 osure <br />FEB 1 199D <br />MINED LAND <br />Please return this form with your completed Annual Report and a check or <br />money order for annual fees due, payable to the Colorado Mined Land Recl.imation <br />Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />ANNUAL REPORT: <br />Map and detail information to follow not later than February Z8, 1990. <br />,. <br />~~=~, <br />Signature <br />n <br />1 I/ <br />y <br />~. <br />